title: Effects of repetitive trascranial magnetic stimulation on repetitive facilitation exercises of the hemiplegic hand in chronic stroke patients.
abstract: OBJECTIVE
  To investigate whether multiple sessions of 1-Hz repetitive transcranial magnetic stimulation (rTMS) facilitates the effect of repetitive facilitation exercises on hemiplegic upper-limb function in chronic stroke patients.
  
  
  METHODS
  Randomized double-blinded crossover study.
  
  
  METHODS
  Eighteen patients with hemiplegia of the upper limb.
  
  
  METHODS
  Patients were assigned to 2 groups: a motor-before-sham rTMS group, which performed motor rTMS sessions for 2 weeks followed by sham rTMS sessions for 2 weeks; or a motor-following-sham rTMS group, which performed sham rTMS sessions for 2 weeks followed by motor rTMS sessions for 2 weeks. Patients received 1-Hz rTMS to the unaffected motor cortex for 4 min and performed repetitive facilitation exercises for 40 min during motor rTMS sessions. The Fugl-Meyer Assessment, Action Research Arm Test (ARAT) and Simple Test for Evaluating Hand Function were used to evaluate upper-limb function. The Modified Ashworth Scale and F-wave were measured to evaluate spasticity.
  
  
  RESULTS
  Motor function improved significantly during the motor, but not sham, rTMS sessions. ARAT score gains were 1.5 (0-4.0) (median, interquartile range) during the motor rTMS session, and 0 (-0.8-1.8) during the sham rTMS session (p = 0.04). Spasticity did not significantly change during either session.
  
  
  CONCLUSIONS
  Multiple sessions of 1-Hz rTMS facilitated the effects of repetitive facilitation exercises in improving motor function of the affected upper limb, but did not change spasticity.
authors.affiliation: Department of Rehabilitation and Physical Medicine, Kagoshima University Graduate School of Medical and Dental Sciences3930-7 Makizono-cho, Kagoshima 899-6603, Japan. etohs@m2.kufm.kagoshima-u.ac.jp.
authors.forename: Seiji
authors.initials: S
authors.lastname: Etoh
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Noma
authors.forename: Keiko
authors.initials: K
authors.lastname: Ikeda
authors.forename: Yuiko
authors.initials: Y
authors.lastname: Jonoshita
authors.forename: Atsuko
authors.initials: A
authors.lastname: Ogata
authors.forename: Shuji
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Megumi
authors.initials: M
authors.lastname: Shimodozono
authors.forename: Kazumi
authors.initials: K
authors.lastname: Kawahira
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000534:rehabilitation; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004576:Electromyography; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006225:Hand; D006429:Hemiplegia / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex; D009128:Muscle Spasticity / Q000534:rehabilitation; D000071939:Stroke Rehabilitation; D050781:Transcranial Magnetic Stimulation; D034941:Upper Extremity